October 2007 - Black Women & Breast Cancer: Second Verse, Same as the First

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Well, it's October–Breast Cancer Awareness Month again, and not much has changed for African-American women since this time last year. In fact, the news is worse. The American Cancer Society estimates that in 2007, approximately 19,000 Black women will be diagnosed with breast cancer, and about 5,800 will die from the disease–roughly 200 more than last year's projected number of 5,600. Moreover, Black women still die from breast cancer at a higher rate–36% higher death rate–than their white female counterparts.

Despite the abundance of public education about mammography and the importance of early detection and treatment over the years, the numbers continue to show a marked disparity between Black women's survival from this disease as compared to other women in the United States. Why? Because even though we do a good job of providing mammograms to women who can't afford them, we don't do a very good job of making treatment affordable. We've got to realize that we don't do poor or uninsured women a favor by offering free mammograms, telling them they have breast cancer, but not offering them a way to pay for their treatment.

Not long ago, I met with representatives from a local hospital to discuss the logistics of a breast cancer screening initiative. I was amazed to learn that although there are many funding sources to provide free mammograms to women who cannot afford them, there is precious little funding available to provide the costly follow-up treatment required if the mammogram indicates further evaluation is necessary. Consider that an initial mammogram that requires a follow-up mammogram, ultra-sound, or MRI, generates additional radiologists' fees; a biopsy generates surgical and pathology fees; a lumpectomy or mastectomy generates more surgical fees and hospitalization costs; and radiation or chemotherapy generates oncologists' fees. If you add to this the costs for childcare during treatment and time lost from work, you have a huge financial burden that many women simply cannot afford. It's no wonder that so many women avoid taking the first step (a mammogram or breast self exam) and simply hope for the best. It's no wonder that by the time many African-American women show up at the doctor, they have waited until the disease has taken over and they have late-stage breast cancer, which is very difficult to treat. It's no wonder that so many Black women are dying–unnecessarily–from this disease. Many women fear the financial consequences of treating the disease as much, if not more, than they fear the disease itself.

We've got to do a better job of providing accessible, affordable treatment for breast cancer patients who can't afford to pay. Research has demonstrated that when Black women and white women with breast cancer at the same stage of the disease receive the same level of care, the outcome is no different. That is, there is no disparity in survival–the Black women's survival is equal to that of the white women. My hope is that in the ensuing year, more funding will be made available to provide accessible, affordable treatment for breast cancer for women who cannot afford it. Increased resources for breast cancer treatment will go a long way to eliminate the disparity in breast cancer survival and begin to turn the tide of survival for Black women. Until that happens, I'm afraid that next year, the statistics for Black women's survival from breast cancer will not, unfortunately, show any improvement over this year's dismal numbers or the numbers that have preceded it for far too long.

With you on your Journey To Wellness...
Dr. Mary S. Harris

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